As people age, many will notice little black threads or dots that seem to float across our vision in one or both eyes. In most cases, they seem to appear suddenly, and when we move our eyes they seem to follow the movement and then slowly drift back to the side or downward.

Over time, many people simply ignore these “floaters” unless they are too numerous or occupy too much of the field of vision to cause actual impairment.

Another phenomenon that can accompany floaters, especially when they first appear, are flashes of light that look something like bursts of lightning. In most cases, these flashes are seen only in the dark. And like floaters, they usually begin in one eye.

Both visual phenomena are the result of shrinkage of the vitreous humor, the jelly-like fluid in the posterior chamber of the eyeball, which is the large hollow area behind the lens. When this happens, the vitreous humor begins to pull away from the retina, forming strands that bridge the gap.

Floaters are the shadows of those strands being projected on the retina. They are more common in people who suffer from nearsightedness (also called myopia), mainly because the eye’s posterior chamber is larger in people who have this condition.

The floater itself is a semitransparent, off-color object. When the eye is moved — such as suddenly looking off to one side — the strands of vitreous humor can tug at the area where they attach to the retina.

As the strands tug at the retina, it causes an electrical discharge in the retinal neurons, which is seen as a brief flash. It’s similar to the effect of rubbing your eyes too hard or getting hit in the eye with your eyelids closed — you see a sudden burst of light.

In most cases, both conditions — the floater and the flash — are harmless. However, in certain cases they can indicate harmful conditions.

For example, the sudden appearance of a large number of floaters accompanied by pain in the eyeball can indicate inflammation within the eye — a condition called uveitis.

Likewise, a sudden appearance of the flashes, especially if they become progressively worse, can be an early sign of a retinal tear and indicate impending retinal detachment, which can lead to permanent blindness. The question I get most often is: Can floaters go away?

In some cases, over time, they can move out of the visual field and even disappear. The brain has the ability to ignore them so that they seem to disappear — a process that once again shows the wonder of the brain.

The flashes of light can also disappear, but that may take several months.However, the appearance of floaters and flashes should not be ignored, especially if they occur suddenly or seem to get worse.

In those cases, you should see an ophthalmologist as soon as possible.

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